Alan Meisel is Quoted in The New York Times on Complexities of End-of-Life Decision Making for Dementia Patients

Published January 20, 2015

The rate of dementia among adults, especially those over 85, is steadily increasing, affecting not only those diagnosed with a degenerative illness such as Alzheimer’s but also the family members who often care for them. A desire to not be a burden on loved ones in the event of their developing a terminal illness leads some to make formal decisions relative to their own end-of-life care. Known as advance directives, these documents might instruct health care professionals not to administer lifesaving treatment like cardiopulmonary resuscitation, ventilators, or feeding tubes. In rare cases, patients might also express a desire for “voluntarily stopping eating and drinking” (VSED). Adding to complexities surrounding this issue, says The New York Times in “Complexities of Choosing an End Game for Dementia,” is whether patients who develop dementia can indicate with an advance directive whether they choose to end their lives through VSED.

Alan Meisel, Pitt Law professor of law and psychiatry; Dickie, McCamey & Chilcote Professor of Bioethics; and director of the University’s Center for Bioethics and Health Law, is an expert on end-of-life decision making. He believes VSED could be among the viable options for people making these decisions. “People in their 50s and 60s frequently say: ‘I don’t want to be in that situation. I don’t want to put my family in that situation.’ And people will increasingly voice those views to others, sometimes in a formal way through advance directives.”

Meisel stresses the importance of not referring to this method of end-of-life care as “starvation,” saying, “It’s the rhetoric more than anything.” He adds that if removing patients from ventilators were suddenly referred to as “suffocation,” that issue might also become contentious.